Menene ciwon sukari na Pancoast kuma ta yaya suke bambanta da sauran cututtukan ciwon huhu a har zuwa bayyanar cututtuka, da kuma magani?
Ƙwararrakin Pancoast ne ciwon huhu na huhu wanda ya fara a saman hagu ko dama kuma ya mamaye asalin murji. An kuma kira su ƙananan cikewar sulcus . Magungunan Pancoast sau da yawa sukan zo tare da bayyanar cututtuka da ake kira "Pancoast syndrome," wanda ya kunshi ciwo a cikin kafada da kuma cikin hannun da hannu.
Magunguna na Pancoast suna da alhakin tsakanin kashi uku da biyar bisa dari na cututtuka na huhu kuma ya bambanta da sauran cututtuka na huhu a hanyoyi masu yawa.
Wuka ciwon huhu na Pancoast irin wannan ciwon daji ne wanda za'a iya rasa saboda dan lokaci kuma saboda wahalar ganin wadannan ciwon sukari a kan nazarin rayukan x-ray da kuma saboda alamun da basu gani ba.
Cutar cututtuka
Kwayoyin cututtukan ƙwayar cutar Pancoast sune saboda matsawa na jiki (jijiyoyi) da ke kusa da ɓangaren ƙwayar cutar da ciwon daji yake. Ana nuna alamar bayyanar cututtuka ta Pancoast-Tobias ciwo da kuma hada da:
- Ƙafafun hannu da kafada yana nuna fuska a hankali (musamman ma a cikin ɓangaren hannu da kuma a kan hannun dutsen na ruwan hoda). Wannan ciwo yana da tsanani kuma ba tare da jinkiri ba. Zama zai iya zubar da ciki a cikin tsaka ko cikin cikin kafada. ( Raunin hannu zai zama alama ta farko na ciwon daji na huhu , musamman ma wadanda ke da ciwon sukari na Pancoast.)
- Dama a hannun tsokoki .
- Tingling da prickly sensations na n hannun, musamman ma zobe da kuma ruwan yatsun ruwan hoda.
- "Horner's syndrome " wanda ya hada da ptosis (eyelid eyelids) anhidrosis (rashin yiwuwar shan taba a gefe daya fuska wanda aka saba da shi ta hanyar fughing da suma a gefe daya fuska) da kuma miosis (ƙwararren ido na ido. )
Wasu lokuta ma akwai kumburi na babba saboda matsin lamba a kan ƙananan ƙwayoyin cuta (ɓacin da yake gudana a ƙarƙashin murfin).
Idan kana da wasu alamomin da ke nuna alamar ƙwayar Pancoast, magana da likitan ka ko samun ra'ayi na biyu. Yawancin wadannan ciwace-ciwacen da aka rasa a farkon saboda alamun su na musamman da kuma saboda suna da wuya a ga rayukan x.
Yanayi da Anatomy
Ƙwararrakin Pancoast na faruwa a cikin ɓangaren dama na damun dama ko hagu (yankin apical) da kuma mamaye tsarin kusa da wannan yanki. Wadannan zasu iya hada da:
- Ribs (sau da yawa a karo na farko da na biyu) da kuma ƙididdiga.
- Plexus na brachial - wani gungu na jijiyoyin dake kusa da dutsen.
- Magunguna ko jini a kusa da saman huhu (misali, maganin ƙwaƙwalwar ƙwayar cuta, jijiya na phrenic, jijiyar laryngeal mai ci gaba, da kuma naman farji.)
Magunguna / Mahimmancin Ma'anar Pancoast Ciwo
Ga wadanda suke son karin bayani mai zurfi game da ciwo na Pancoast, Cibiyar Kwalejin Kwalejin Kasuwancin Amirka ta bayyana cewa ciwon huhu na Pancoast kamar ciwon huhu ne wanda ya mamaye duk wani nau'i na gwaggwon biri, ciki har da ƙwayoyi na farko na thoracic , ƙananan ciwon jijiya na plexus na bronchial, sarkar juyayi da kuma ganglion da ke kusa da kodin kirji ko ƙananan jirgi (ƙananan jiragen ruwa sun haɗa da maganin daji da tafiya da ke tafiya a ƙarƙashin murƙarar ƙirar ko ƙaya.)
Dalilin
Shan taba yana da alhakin yawancin wadannan cututtuka, amma yana da muhimmanci a lura cewa cutar sankarar mahaifa ta fi dacewa a cikin tsoffin smokers fiye da mutanen da ke shan taba yanzu. Sauran cututtuka na ciwon daji na huhu sun hada da radon hotuna , shan taba, da halayen sana'a ga sunadaran da abubuwa da aka sani don cutar ciwon huhu.
Sanin asali
Binciken na ciwon sukari na Pancoast akai-akai ana jinkirta dalilai biyu. Wadannan ciwon sukari ba su da wata alamar bayyanar cututtuka na huhu , irin su takaicin numfashi da tari, kuma mutane sukan fara ganin likita ko likitancin likita don alamun su.
Magunguna na Pancoast kuma suna da wuyar gani a hasken rayukan kirji saboda wurin su.
Haɗin haɗin CT da kuma MRI suna amfani da su-da MRI da muhimmanci kafin a tilasta su nema don shiga nadama. Kwayar kwayar halitta ta wasu nau'i-ko wani ɓoyayyen kwakwalwa (ƙwayoyin maganin) ko ta hanyar kwayoyin halitta na lymph a sama da kasusuwan (suturar kwayoyin halitta) wanda ake amfani da shi don tabbatar da asali. Sauran gwaje-gwaje, irin su bronchoscopy na iya yin haka.
Tsarin
Ana yin gyaran kafa tare da hade PET scan / CT. Yawancin wadannan cututtuka ne na IIB marasa ciwon ƙwayar cutar ciwon huhu. Bisa ga cutar kanjamau na TNM , mafi yawansu sune T3 ko T4.
Kwayar Ciwon Kanji
Magungunan ƙwayoyin Pancoast yawanci al'amuran ciwon daji ne marasa ƙananan kwayar cutar. Daga cikin waɗannan, a kusa da 2/3 su ne adenocarcinoma da kuma 1/3 su ne karamin cell cellcin ko babban cellcin carcinoma. Tun da akwai hanyoyi da dama da aka kera a yanzu suna samuwa ga adinocarcinoma , kuma a yanzu don ƙwayar ƙwayar ƙwayar mota, yana da matukar muhimmanci a tabbatar cewa kana da labarun (kwayoyin wallafe-wallafe) da aka yi a kan ciwon ka.
Jiyya
Hanyoyin magani don mutanen da ke fama da ciwon sukari na Pancoast suna dogara ne akan ƙananan ciwon sukari. A halin yanzu, ga wadanda suke da mataki na na ci gaba da ciwon ciwon sukari na duniya, ma'anar "manufa" ta hada da haɗuwa da cutar shan-jiji da radiation wanda ya biyo bayan tiyata. Zabuka sun haɗa da:
Chemotherapy da kuma magance hanyoyin kwantar da hankali
Jiyya ga ƙwayar cutar Pancoast yawanci yakan fara da ciwon daji na ciwon huhu na huhu , ko yanda ba tiyata ba zai yiwu. Dangane da wurin da zai iya yin tiyata mai wuyar gaske, burin shine rage ƙwayar ƙwayar cuta kamar yadda ya kamata kafin aikin tiyata. Bugu da ƙari, yawancin wadannan ciwon sukari suna da "maye gurbi" - ƙwayoyin cuta wadanda suka samo a gwajin gwaji don samo asibiti. Idan baku da gwajin gwaje-gwaje, wanda ake kira labaran kwayoyin ko lalata harshe, magana da likitan ku.
Tiyata
Ana iya yin tiyata sau ɗaya a kan ciwon sukari na Pancoast, amma yawanci ana aikatawa bayan shan magani da kuma / ko cike da magungunan ci gaba da radiation don magance ciwon sukari. Chemotherapy kafin a tiyata ana kiransa "farfadowa." Wannan tiyata yana da wuyar gaske, kuma yana da mahimmanci don samun cibiyar ciwon daji wanda likitoci sun saba da wannan ƙwayar cuta. Ba kamar wasu cututtuka da suka yada ga kasusuwa ba, wasu mutane tare da ciwon sukari na Pancoast wanda suka mamaye vertebrae za a iya magance su tare da tiyata. A lokacin aikin tilasta, an cire magungunan lymph a cikin kirji tsakanin huhu (wanda ake kira magungunan lymph).
Radiation far
Idan magani da nufin maganin lafiya ba zai yiwu ba, farfadowa na radiation zai iya zama mai taimako a matsayin farfadowa na farfadowa - wanda aka yi amfani da shi don taimakawa ciwo da sauran cututtuka. Hakanan za'a iya amfani da maganin radiation tare da chemotherapy don "raguwa" ƙwayar ci gaba kafin tiyata.
Farfesa da aka tsara
Kamar yadda muka gani a sama, kowa da kowa tare da marasa ciwon huhu na huhu ba tare da ƙananan ƙwayar cuta ba musamman ya kamata adenocarcinoma ya kamata a yi amfani da labarun kwayoyin cutar a jikin su. Ana amfani da magunguna yanzu ga wadanda ke tare da maye gurbin EGFR , gyare-gyaren ALK , ROS1 sake fasalin , da sauransu, tare da ƙarin maganin da ake binciken a gwaji.
Immunotherapy
Immunotherapy abu ne mai ban sha'awa don magance ciwon huhu na huhu, tare da farkon jiyya da aka yarda a cikin wannan rukunin a shekarar 2015. Duk da yake ba ya aiki ga kowa da kowa, wasu mutane-ko da wadanda ke fama da ciwon huhu na ciwon huhu - sunyi kula da cutar su da dadewa wadannan jiyya.
Gwajin gwaji
Ƙwararren Pancoast suna da wuya, kuma gwaji na gwaji suna ci gaba don kimanta sababbin jiyya.
Faɗakarwa
An samu ci gaba mai kyau a rayuwa daga ciwon sukari na Pancoast a cikin 'yan shekaru da suka wuce. Gaba ɗaya, ciwon sukari na Pancoast suna da ƙwarewa mafi kyau fiye da ciwace-ciwacen da aka samo a tsakiya a cikin huhu, kuma yawan lafiyar na iya zama mafi alhẽri fiye da sauran cututtuka a irin wannan mataki
An gano tsawon rayuwa na tsawon shekaru 2 tsakanin 55 da kashi 70 cikin dari-wanda ya fi girma fiye da wasu cututtukan huhu, da kuma wadanda ke da ciwon sukari na Pancoast wanda za'a iya magance su tare da tiyata, tsawon shekaru 5 na rayuwa tsakanin 50 da 77 kashi.
Yana da mahimmanci a lura cewa waɗannan nauyin rayuwa zasu iya zama mafi girma a yanzu, tun da sababbin magunguna, da magungunan immunotherapy, an yarda da su tun lokacin da aka kammala karatun.
Idan An Bincika Ka
Tun da ciwon sukari na Pancoast abu ne wanda ba a sani ba, kuma tun da yake aikin tiyata yana da kyau, yana da mahimmanci a yi la'akari da samun ra'ayi na biyu idan an gano ka da kututtukan Pancoast. Nazarin ya gaya mana cewa ilmantarwa da yawa game da ciwon daji ba kawai yana taimaka maka ka ji daɗin sarrafawa ba amma zai iya taimakawa tare da sakamakonka. Bincika waɗannan shawarwari kan abin da za ku yi lokacin da aka saba gano ku , da kuma yadda za a gudanar da bincike kan ciwon daji a kan layi .
Kasancewa da kanka don kulawa da ciwon daji ya haifar da bambanci ga mutane da dama, kuma a cewar Cibiyar Cancer ta Cancer, mutanen da ke fama da ciwon huhu ya kamata su yi la'akari da zabin gwaji.
Kuna iya jin karin bayani game da ciwon nono da ruwan yarinya, amma mahaukacin ciwon huhu na huhu yana aiki da goyon baya sosai. Ko da ma ba kai ne irin mutumin da ke goyon bayan ƙungiyoyi ko kafofin watsa labarun ba, ka yi la'akari da haɗawa da wasu da ke fama da wannan cuta.
Kuma, idan yana ƙaunarka wanda aka gano a maimakon haka, ya kamata ka koyi abin da ya kamata ka yi idan mai ƙaunataccen ciwon huhu yake .
> Sources:
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